National Wear Red Day: February 7, 2020

February begins American Heart Month, and organizations like the American Heart Association would like to raise awareness in heart health and to remind people of the dangers of heart disease. More specifically, Friday, February 7, 2020 is National Wear Red Day in which the American Heart Association wants to spotlight raising heart health awareness in women. Know the facts, know signs/ symptoms, and know your risk factors.

What are the facts of about Heart Disease in Women: Did you know that heart disease is the Number One killer of women, causing 1 in every 3 deaths in the United States every year? Unfortunately, only 1 in 5 American women believe that heart disease is her greatest health threat.

What are the Signs and Symptoms of Heart Attack:

• Chest pain lasting more than a few minutes

• Pain in one or both arms, back, neck, jaw

• Difficulty breathing

• Nausea, lightheadedness, cold sweats

What are Risk Factors for Heart Disease:

• High Blood Pressure

• Smoking

• High Cholesterol

• Diabetes

• Being Overweight

• Lack of Regular Activity

Finally, here are Five Numbers that you need to know to take control of your heart health:

• Total Cholesterol

• HDL (good) Cholesterol

• Blood Pressure

• Blood Sugar

• Body Mass Index (BMI)

Really finally, I’ll be on WKBN-TV on February 2, 2020 during their morning show talking about American Heart Month and Go Red For Women Day. Enjoy the videos below from an interview from 10 years ago, from 2010! Wow! Hard to believe it’s been that long since that interview…

Early Flu Season 2020

Flu season has hit early in Ohio and nationally. According to the Centers for Disease Control (CDC), Ohio is one of 45 other states now designated as “Widespread” flu activity, which is further emphasized by the Ohio Department of Health (ODH). Early January is typically an earlier time for flu cases to be spiking, but not unusual.

Last Friday, ODH stated that 387 hospitalizations in the state of Ohio were influenza related from December 22 through December 28. Unfortunately, Ohio had its first pediatric death of this flu season which occurred on New Year’s Eve who was a 16 year old high school student from Berea.

In the news of this death, I’ve been receiving a lot of questions from my patients about influenza. No, it’s never too late to get your flu shot. Who is at high risk to get the flu? These risk groups include adults 65 years and older, children younger than 2 years old, pregnant women, and those with chronic medical problems like diabetes, asthma, COPD, and others. Check with your Family Physician to see if you are in one of these high risk groups.

What are the signs and symptoms of influenza? Unlike a cold, flu symptoms come on suddenly. I should know because I have gotten the flu myself on more than one occasion in the past. Flu symptoms include fever, chills, muscle aches, cough, and headache. Most adults may be able to infect others beginning from one day before symptoms and up to 5-7 days after becoming sick.

How to prevent influenza and the spread of the flu? In addition to getting your flu shot, there are some everyday preventative actions that can help prevent the spread of germs, like frequent handwashing, covering coughs and sneezes and staying away from people who are sick. Of course, seek medical attention if you think you have any kind of flu symptoms.

Physician as Patient

Christmas Eve was fabulous! I had a television interview about how to stay healthy during the holidays. I went to Christmas Eve mass with my family and in the church that I was married in. And, I had a great dinner with family and opening of gifts. Little did I know that things were going to turn poorly and quickly.

It was the early morning hours of Christmas, when I had an ongoing pain in my abdomen area. I’ve been prone to stomach problems in the past, specifically what they call “stomach reflux” in which there is too much stomach acid produced. Usually in the past, I would take an antacid, and my symptoms would get better, but not this time.

At around 3am on Christmas morning, it was time to go to the emergency room at the hospital. I cannot say enough great things about about the emergency department physician and the ED staff in my care over the next few hours, and they tried to figure out what was going on with me. As I was being wheeled up to my hospital room, we heard a voice down the hall, calling us back to the ED, because they found what the problem was. In the course of my testing, it was found that my gallbladder had many stones, and lots of inflammation. This meant that I would need emergency surgery on Christmas Day to remove my gallbladder.

The last thing I remember was being wheeled into the operating room and seeing my surgeon telling me that everything was going to be all right. When I woke up, what I remember was being late into Christmas night and having pain, but not as much abdominal pain as when I was in the ED.

In the next few hours and days would be my recovery. Like many other people who have been in a situation like that (after major surgery), it serves as a “wake up call” for me. It’s no secret that I could be taking care of myself in a better way, when it comes to my physical health. It’s also no secret that many health professionals keep everyone else first, instead of taking care of themselves. This is why you’ve seen and heard and read a lot about physician burnout in the past few months.

Now, that it’s a week later, I have made some changes in my lifestyle. I’m eating better and doing things like meal planning for the day and week (something that I’ve never done before), I’m blocking out time for exercise (something that I seldom did in the past), and I’m using a smartphone app to try to keep myself accountable. As far as what I’m eating these days, I’m following most of what is known as the Mediterranean Diet as recommended by the American Heart Association.

There are three lessons that I have learned that I want to pass along to all of you. First, all of us, even physicians, will be come patients some day. We are not invincible, and sometimes denial is a very powerful tool to help you ignore your health. This leads me to my second lesson: Listen to your body. I know that this sounds simple. If something feels wrong, you need to have it checked out. Finally, seek help when needed. Many people are afraid of what will be found, like cancer. Without seeking out your Family Physician, how are going to really know. And, not knowing, sometimes is the worst thing.

Finally, I want to give a shout out to my friends and colleagues at Salem Regional Medical Center. Their care and attention and listening really helped my wife and I navigate through and got me on the road to recovery. I hope to continue to share my recovery story in the days and the weeks to come. Feel free to reach out to me on My Facebook Page. It’s definitely a Happy New Year for me, and I hope for you as well…

Are You SAD (Seasonal Affective Disorder)

As the holidays quickly approach, you would think that it should be the happiest time of the year. Unfortunately, for some of my patients, it is the toughest time of the year, especially as the first day of winter is right around the corner. For those with depression symptoms that occur around the same time each year, the diagnosis of Seasonal Affective Disorder, or SAD, comes to mind.

In most cases, SAD occurs in late fall or early winter, like the first day of winter, which is the day with the least amount of light for the entire year. Typically, these SAD symptoms last through the winter and improve the next spring.

Symptoms of SAD include the urge to socially withdraw from others, a desire to be alone, low energy, excessive sleep, craving carbohydrates, weight gain, and irritability.

Who is at risk for SAD? Risk factors include younger people (SAD even diagnosed in children and teens), having a personal history of depression, having a family history of depression, and being female.

There are a variety of treatments for SAD. You may have heard of these special type of light boxes that can be purchased. Experts recommend exposure of 10,000 Lux of cool-white fluorescent light for about 20-60 minutes, which is about 20 times more intense than ordinary indoor lighting. Other treatments include medication therapy and traditional counseling and therapy.

When should someone see a doctor? It’s normal to have an occasional day when you feel down during the winter. However, if you feel down for many days in a row or start to lack motivation to do your normal daily activities, this may be a time to visit your doctor. Very worrisome risk factors include significant withdrawal from social activities, using alcohol to help with sleep or with depression, and feelings of hopelessness or thoughts of suicide. (If you know of anyone at risk of suicide, please get them to the Emergency Room or share with them the National Suicide Prevention Hotline: 800-273-8255)

So, as the holidays get closer, please recognize that for some people, they may be having difficulties with depression. recognize the signs and symptoms, and if needed, get them to see their Family Doctor as soon as they can.

CBD: Is it worth the hype?

What Is CBD?

• Derived from the Hemp Plant

• Not Marijuana

• Does not give “high” like THC

CBD claims to help the following:

• Chronic pain

• Anxiety

• Treats insomnia

• More research is needed

In the past few months, I have seeing lots and lots of signs around town advertising something called CBD. I mean, you can even get some CBD with your video rental or with some local pizza. What is CBD and why as almost everyone been selling it, just in the past few months? That’s what this article will tackle.

What is CBD? CBD stands for Cannabidiol. This is derived from the hemp plant, which is a cousin of the marijuana plant. Many people are familiar with THC, which gives people that “high” feeling. CBD does not give that “high” feeling.

How does CBD claim to help people? You’ll see that CBD claims to help people with their chronic pain symptoms, anxiety symptoms, and helps to treat insomnia. There is some research that talks about these claims, but the research is limited, and needs more study. Other claims that are made say that CBD helps with nausea, reduces acne, and helps symptoms related to cancer and side effects of cancer treatment like nausea and vomiting. Side effects of CBD include occasional diarrhea, fatigue, and changes in appetite.

Isn’t CBD approved by the FDA? The only FDA indication for CBD has to do with treatment of rare childhood epilepsy syndromes. The FDA medication is called “Epidolex” and can only be obtained by prescription. This FDA medication treats conditions like Dravet Syndrome and Lennox-Gaustaut Syndrome. So, when you hear that CBD is FDA approved, it is only for these childhood epilepsy syndromes, and nothing else.

Why has CBD advertising exploded in Ohio? On July 30, 2019, Governor Dewine signed Senate Bill 57 into law, and immediately decriminalized hemp in Ohio. So, this meant that stores are allowed to sell hemp-derived CBD. In Ohio, CBD can he sold as an oil, edibles, and tincture to balms, lotions, sprays, and even pet treats.

What’s the bottom line on CBD? At this point, I do not think that CBD is worth the hype. Definitely, more research is needed to confirm the possible health benefits of helping chronic pain, anxiety, and treating insomnia. In addition, CBD is like any other supplement, there is no regulation on these products. So, you actually don’t know how much CBD you’re getting whether its 5% or 10% or whatever. Finally, and most importantly, there can be still trace amounts of THC in any CBD product, which can potentially show up in drug testing. So, beware of possible positive marijuana when taking CBD. Something to think about…

Vaping Related Lung Injuries Reach 530 Cases & 7 Deaths

The Centers for Disease Control and Prevention just announced a huge jump in confirmed cases of lung injury associated with vaping. Last week, 380 cases confirmed, and this week 530 cases confirmed, including seven deaths confirmed from six states. In Ohio, the Ohio Department of Health confirmed that there have been 17 cases in the buckeye state with zero deaths, up to this point.

Digging down deeper in the CDC data, nearly three fourths (72%) of cases are male. Two-thirds (67%) of cases are 18-34 years old. But, very surprising to me was that 16% of cases are under 18 years old. I guess that shouldn’t surprise me because data from the 2018 National Youth Tobacco Survey showed that more than 3 million high school students used e-cigarettes which is a 78 percent increase from 2017.

Possible Signs/Symptoms of Vaping Lung Injury

• Rapid Onset of Coughing

• Rapid Onset of Breathing Difficulties

• Weight Loss, Nausea, Vomiting, Diarrhea

CDC Recommendations on Vaping

• If any symptoms, consult your doctor immediately

• No Vaping for Youth and Young Adults

• For Adults: Consider stopping vaping until we know more

• “Safe Vaping”: Don’t buy off the street products or modify current product

I’ve been receiving a lot of questions from patients, from families, and from community members on this topic. Unfortunately, there is still a lot that we do not know yet. For example, we do not know the exact cause of the deaths related to the vaping lung injuries. Looking on the internet, there are a lot of theories out there like “lipoid pneumonia” or “acute eosinophilic pneumonia.” But, we still haven’t found a definite pattern yet.

What is causing the illnesses? Again we don’t know. There have been illnesses reported in those who used nicotine vaping products, THC vaping products, or both vaping products. In addition to these, the American Lung Association states that there other chemicals in e-cigarettes like propylene glycol, vegetable glycerin, acetaldehyde, acrolein, formaldehyde, and others.

Are flavored vapes more likely to be dangerous? Again, we don’t know that either. In the news this week, there has been talk about the banning of all non-tobacco flavored e-cigarettes from the market. Some agree with this, and some disagree. But, I don’t think that there is a doubt that the child-friendly vaping flavors are a gateway to nicotine-vaping, cigarette use, and possibly other substances (see my 2016 local TV interview below). Definitely ban vaping (tobacco or non tobacco vaping) for those younger than 21. But, a blanket ban for flavored vape products for everyone, including those 21 and older, is a step too far, in my opinion.

Finally, I’ve been asked if this is a new phenomenon in vaping, or is it just recognized more now than years ago when vaping started. Again, this is hard to say. Something that we can all agree on is that more study and research is needed before medical evidence can be generated. And, hopefully, the medical evidence that is generated will translate into sensible public policy decisions. Time will tell….

Report from WKBN-TV on December 9, 2016

Interview from April 1, 2018 on WKBN-TV

Five Health Tips for Back To School

It’s hard to believe that another summer is quickly coming to a close. As back to school is right around the corner, here are five health tips to help get you and your kids ready. I encourage you to check out these tips from the Centers for Disease Control in addition to my tips below.

1. Visit Your Doctor: In Ohio, especially before Kindergarten, 7th grade, and 12th grade, there are required immunizations that need to be completed so that the child can enter school. These immunizations are described and listed on this link from the Ohio Department of Health. In addition, depending on your child’s age and medical conditions, there may be other immunizations that are recommended. So, definitely check with your doctor on this.

2. Change That Sleep Schedule Now: Studies have shown that adequate sleep is critical for academic success. For adults, it can take about a week to get used to a new sleep schedule. However, in young children, it can take longer than that. Consider starting that new (and earlier) sleep schedule now. A good first step is to have the child limit screen time or just turn off electronic devices well before bedtime.

3. Kids Needs Breakfast: Studies also show that children who eat a healthy breakfast function better. I encourage parents to check with the school to see what is available in the cafeteria, and most schools have this available on their school website. In addition, some children qualify for free or reduced meals at school, but parents need to check with the school in regards to this.

4. Backpack Safety: Choose a backpack with wide padded shoulder straps and a padded back. Remind your child to always use both shoulder straps. Pack light, and remove unneeded items. The backpack should never weigh more than 10-20% of your child’s body weight.

5. Beware of Bullying: Teach your child when and how to ask a trusted adult for help at school. Monitor your child’s social media and text interactions so you can identify problems before they get out of hand.

These are just a few tips to get you started. The bottom line is that this is such an exciting time for kids as they start out the new academic year. Don’t forget to have some fun in the process of getting ready to go back to school!

Heat Stroke Leading Cause of Death in High School Athletes

Heat Illness Statistics

• Heat Illness is A Leading Cause of Death in US High School Athletes

• Since 1995, Three Football Players Die A Year of Heat Stroke, Mostly HS athletes

• From 1999-2000, more than 8000 heat-related deaths in US

Heat Illness Prevention For HS Athletes

• Slow Increase in Pre-Season Practice and Intensity

• Hydrate Before, During, and After Practice

• Recognize Signs and Symptoms of Heat Illness

We’ve been hearing all week about the hottest temperatures of the season happening right now. However, with August and back to school right around the corner, I’ve also been reminding my high school patients and their parents that heat related illnesses can still occur when it’s not so hot and humid.

Here are some alarming statistics. According to the CDC, heat illness during practice or competition is a leading cause of death and disability among US high school athletes. In addition, since 1995, three football players a year on average die of heat stroke, most of them high schoolers, according to the National Center for Catastrophic Sports Injury Research. From 1999-2010, more than 8000 heat-related deaths were reported in the US (CDC).

Those high school students who have activities in the fall include those in football, soccer, cross country, golf, cheerleading, and even marching band. Traditionally, in July and August, these athletes are not as physically fit as opposed to when they officially begin. We do know that lack of physical activity and obesity are additional risk factors for heat-related illnesses.

Specifically for high school athletes, I recommend three tips to lower your chance of heat related illnesses. First, especially in July and August, slowly increase your pre-season practice schedule, especially in hot and humid weather. This will help your body get more acclimated to the hot temperatures. Secondly, remember to properly hydrate before, during, and after strenuous activity. Finally, I talk to these athletes about recognizing the signs and symptoms of heat-related illness.

We’ve been hearing all week that signs and symptoms of heat related illnesses include dehydration, heat cramps, nausea, vomiting, headache, dizziness, and confusion. If athletes start to notice and/or recognize any of these symptoms, tell your coach or parent immediately. Prevention is critical, and it may save a life.

Addendum: Thanks to WKBN for making this blog post into a story on their website: “Preventing heat stroke: Know the signs of heat-related illness.”

June is Fireworks Safety Month

Firework Safety Tips

• Never allow young children to handle fireworks

• Older children should only use fireworks under close adult supervision

• Never light fireworks indoors

• Never relight a “dud” firework

• Soak unused fireworks in water before discarding

• Keep a bucket of water nearby to extinguish fireworks

As the first day of summer and the July 4th holiday is right around the corner, it’s important to talk about some summer safety tips. Did you know that June is Fireworks Safety Month?

According to the Consumer Product Safety Commission, approximately 12,900 injuries were treated at the US emergency rooms in 2017, with more than two-thirds of those injuries occurring 1 month around the July 4th holiday.

Another interesting fact is that on a typical Fourth of July, fireworks account for two of five of all reported fires, according to the National Fire Protection Association (NFPA). CHeck out the video below from the NFPA.

Check out some helpful tips above. Better yet, grab a blanket and a patch of lawn, kick back and let the experts handle the show!

Mother's Day Health Tips

Happy Mother’s Day to all the moms out there! Thanks for all that you do, which includes taking care of everyone else. Unfortunately, this sometimes means that mom puts her health and well-being last. Here are five tips from the Centers for Disease Control and Prevention that I want to share with moms of every age for a safer and healthier life (CDC).

Eat Healthy: Healthy diets rich in fruits and vegetables may reduce the risk of cancer and other chronic diseases. Fruits and vegetables also provide essential vitamins and minerals that are important for good health. Most fruits and vegetales and filling and naturally low in fat and calories.

Move More: Add physical activity to your life, in whatever capacity you can. I know that some have difficulty with movement, but every little bit helps. Health benefits include better control of your weight, reducing risk of heart disease, reducing risk of diabetes, and some other diseases. More movement also can strengthen your muscles and bones, and also improve your mood.

Sleep Well: Insufficient sleep is associated with increased risk for many chronic diseases like disease, heart disease, and depression. How you perform during the day is related to how much sleep you had the night before.

Manage Stress: I realize that this is easier said than done. But, there are healthy and unhealthy ways to manage stress. I encourage my patients positive self-care steps like leaning on your support system, staying physically active, connecting socially, and other self-care steps. And, of course, avoid alcohol, tobacco, drugs and other unhealthy behaviors.

Share History: Mother’s Day is a perfect day to teach and pass on family medical history. Family members share genetics, environments, and lifestyles that may influence the health of others in the family. Your family’s health history could be important for determining your and your child’s health risks as well.